Attendance at remote versus in-person outpatient appointments in an NHS Trust

Gabriele Kerr; Geva Greenfield; Benedict Hayhoe; Fiona Gaughran; Kristoffer Halvorsrud; Mariana Pinto da Costa; Nirandeep Rehill; Rosalind Raine; Azeem Majeed; Ceire Costelloe; Ana Luisa Neves; Thomas Beaney

doi:10.1177/1357633X231216501

Attendance at remote versus in-person outpatient appointments in an NHS Trust

Gabriele Kerr^*, Geva Greenfield, Benedict Hayhoe, Fiona Gaughran, Kristoffer Halvorsrud, Mariana Pinto da Costa, Nirandeep Rehill, Rosalind Raine, Azeem Majeed, Ceire Costelloe, Ana Luisa Neves, Thomas Beaney^*

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

2 Citations (Scopus)

Abstract

Introduction: With the growing use of remote appointments within the National Health Service, there is a need to understand potential barriers of access to care for some patients. In this observational study, we examined missed appointments rates, comparing remote and in-person appointments among different patient groups. Methods: We analysed adult outpatient appointments at Imperial College Healthcare NHS Trust in Northwest London in 2021. Rates of missed appointments per patient were compared between remote versus in-person appointments using negative binomial regression models. Models were stratified by appointment type (first or a follow-up). Results: There were 874,659 outpatient appointments for 189,882 patients, 29.5% of whom missed at least one appointment. Missed rates were 12.5% for remote first appointments and 9.2% for in-person first appointments. Remote and in-person follow-up appointments were missed at similar rates (10.4% and 10.7%, respectively). For remote and in-person appointments, younger patients, residents of more deprived areas, and patients of Black, Mixed and ‘other’ ethnicities missed more appointments. Male patients missed more in-person appointments, particularly at younger ages, but gender differences were minimal for remote appointments. Patients with long-term conditions (LTCs) missed more first appointments, whether in-person or remote. In follow-up appointments, patients with LTCs missed more in-person appointments but fewer remote appointments. Discussion: Remote first appointments were missed more often than in-person first appointments, follow-up appointments had similar attendance rates for both modalities. Sociodemographic differences in outpatient appointment attendance were largely similar between in-person and remote appointments, indicating no widening of inequalities in attendance due to appointment modality.

Original language	English
Journal	Journal of Telemedicine and Telecare
DOIs	https://doi.org/10.1177/1357633X231216501
Publication status	Accepted/In press - 2023

Keywords

eHealth
remote consultation
telecare
telehealth
telemedicine

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1177/1357633X231216501

Cite this

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title = "Attendance at remote versus in-person outpatient appointments in an NHS Trust",

abstract = "Introduction: With the growing use of remote appointments within the National Health Service, there is a need to understand potential barriers of access to care for some patients. In this observational study, we examined missed appointments rates, comparing remote and in-person appointments among different patient groups. Methods: We analysed adult outpatient appointments at Imperial College Healthcare NHS Trust in Northwest London in 2021. Rates of missed appointments per patient were compared between remote versus in-person appointments using negative binomial regression models. Models were stratified by appointment type (first or a follow-up). Results: There were 874,659 outpatient appointments for 189,882 patients, 29.5% of whom missed at least one appointment. Missed rates were 12.5% for remote first appointments and 9.2% for in-person first appointments. Remote and in-person follow-up appointments were missed at similar rates (10.4% and 10.7%, respectively). For remote and in-person appointments, younger patients, residents of more deprived areas, and patients of Black, Mixed and {\textquoteleft}other{\textquoteright} ethnicities missed more appointments. Male patients missed more in-person appointments, particularly at younger ages, but gender differences were minimal for remote appointments. Patients with long-term conditions (LTCs) missed more first appointments, whether in-person or remote. In follow-up appointments, patients with LTCs missed more in-person appointments but fewer remote appointments. Discussion: Remote first appointments were missed more often than in-person first appointments, follow-up appointments had similar attendance rates for both modalities. Sociodemographic differences in outpatient appointment attendance were largely similar between in-person and remote appointments, indicating no widening of inequalities in attendance due to appointment modality.",

keywords = "eHealth, remote consultation, telecare, telehealth, telemedicine",

author = "Gabriele Kerr and Geva Greenfield and Benedict Hayhoe and Fiona Gaughran and Kristoffer Halvorsrud and {Pinto da Costa}, Mariana and Nirandeep Rehill and Rosalind Raine and Azeem Majeed and Ceire Costelloe and Neves, {Ana Luisa} and Thomas Beaney",

note = "Publisher Copyright: {\textcopyright} The Author(s) 2023.",

year = "2023",

doi = "10.1177/1357633X231216501",

language = "English",

journal = "Journal of Telemedicine and Telecare",

issn = "1357-633X",

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T1 - Attendance at remote versus in-person outpatient appointments in an NHS Trust

AU - Kerr, Gabriele

AU - Greenfield, Geva

AU - Hayhoe, Benedict

AU - Gaughran, Fiona

AU - Halvorsrud, Kristoffer

AU - Pinto da Costa, Mariana

AU - Rehill, Nirandeep

AU - Raine, Rosalind

AU - Majeed, Azeem

AU - Costelloe, Ceire

AU - Neves, Ana Luisa

AU - Beaney, Thomas

PY - 2023

Y1 - 2023

N2 - Introduction: With the growing use of remote appointments within the National Health Service, there is a need to understand potential barriers of access to care for some patients. In this observational study, we examined missed appointments rates, comparing remote and in-person appointments among different patient groups. Methods: We analysed adult outpatient appointments at Imperial College Healthcare NHS Trust in Northwest London in 2021. Rates of missed appointments per patient were compared between remote versus in-person appointments using negative binomial regression models. Models were stratified by appointment type (first or a follow-up). Results: There were 874,659 outpatient appointments for 189,882 patients, 29.5% of whom missed at least one appointment. Missed rates were 12.5% for remote first appointments and 9.2% for in-person first appointments. Remote and in-person follow-up appointments were missed at similar rates (10.4% and 10.7%, respectively). For remote and in-person appointments, younger patients, residents of more deprived areas, and patients of Black, Mixed and ‘other’ ethnicities missed more appointments. Male patients missed more in-person appointments, particularly at younger ages, but gender differences were minimal for remote appointments. Patients with long-term conditions (LTCs) missed more first appointments, whether in-person or remote. In follow-up appointments, patients with LTCs missed more in-person appointments but fewer remote appointments. Discussion: Remote first appointments were missed more often than in-person first appointments, follow-up appointments had similar attendance rates for both modalities. Sociodemographic differences in outpatient appointment attendance were largely similar between in-person and remote appointments, indicating no widening of inequalities in attendance due to appointment modality.

AB - Introduction: With the growing use of remote appointments within the National Health Service, there is a need to understand potential barriers of access to care for some patients. In this observational study, we examined missed appointments rates, comparing remote and in-person appointments among different patient groups. Methods: We analysed adult outpatient appointments at Imperial College Healthcare NHS Trust in Northwest London in 2021. Rates of missed appointments per patient were compared between remote versus in-person appointments using negative binomial regression models. Models were stratified by appointment type (first or a follow-up). Results: There were 874,659 outpatient appointments for 189,882 patients, 29.5% of whom missed at least one appointment. Missed rates were 12.5% for remote first appointments and 9.2% for in-person first appointments. Remote and in-person follow-up appointments were missed at similar rates (10.4% and 10.7%, respectively). For remote and in-person appointments, younger patients, residents of more deprived areas, and patients of Black, Mixed and ‘other’ ethnicities missed more appointments. Male patients missed more in-person appointments, particularly at younger ages, but gender differences were minimal for remote appointments. Patients with long-term conditions (LTCs) missed more first appointments, whether in-person or remote. In follow-up appointments, patients with LTCs missed more in-person appointments but fewer remote appointments. Discussion: Remote first appointments were missed more often than in-person first appointments, follow-up appointments had similar attendance rates for both modalities. Sociodemographic differences in outpatient appointment attendance were largely similar between in-person and remote appointments, indicating no widening of inequalities in attendance due to appointment modality.

KW - eHealth

KW - remote consultation

KW - telecare

KW - telehealth

KW - telemedicine

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U2 - 10.1177/1357633X231216501

DO - 10.1177/1357633X231216501

M3 - Article

AN - SCOPUS:85180433904

SN - 1357-633X

JO - Journal of Telemedicine and Telecare

JF - Journal of Telemedicine and Telecare

ER -

Attendance at remote versus in-person outpatient appointments in an NHS Trust

Abstract

Keywords

UN SDGs

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